The applicant has a unique background in studying health care transitions from pediatric to adult health care given her dual board in internal medicine and pediatrics combined with a health services research background through the Robert Wood Johnson Clinical Scholar Program. Her research is aimed at studying and formulating interventions that will address barriers and facilitators to chronic illness care for children with special health care needs as they transition from the pediatric to adult health care setting. The applicant has extensive experience in quantitative methods and survey development through her previous work. Through the proposed career development activities she seeks to gain additional skills toward being an independent investigator through the proposed program of training in qualitative research methods, studies in longitudinal data analysis, and in program development and evaluation. Her research agenda is to generate rigorous evidence to improve the quality of health care provided to patients through interventions that integrate patients, health care providers, health care systems and community organizations. The applicant proposes to accomplish this through two main objectives in this career development award. First, she will study what particular barriers and facilitators exist for youth and young adults with complex chronic conditions during the transitioning period. She will be using a mixed methods approach combining information from in-depth qualitative interviews with results from quantitative analyses of the 2005-2006 National Survey for Children with Special Health Care Needs. Second, she will take the information from the descriptive studies to design, implement and evaluate a city-based pilot intervention. This intervention is being created to improve health care delivery for youth and young adults with special health care needs as they age into the adult health care system via improved linkages to providers and community organizations. Through the proposed career development activities, the applicant seeks to acquire new skills in qualitative methods and advanced quantitative skills that will complement her existing research skills in order to improve health care delivery to youth and young adults with complex chronic conditions. [unreadable] [unreadable] [unreadable]